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Strengthening the Referral System and Adjustments to National Health Insurance Co-Payments for Outpatient and Emergency Visits

  To strengthen the referral system, the Ministry of Health and Welfare (MOHW) announced on February 18, 2017 that adjustments will be made to the co-payments that the National Health Insurance (NHI) insured have to pay for inpatient and emergency visits.

  Following a series of explanations, communications and public hearings, reports by the NHI Supervisory Board, public hearings convened by multiple legislators, and meetings held by private groups, notices were made in accordance with the law between January 24 and February 6, 2017, during which revision suggestions were provided by the Taiwan Hospital Association, Taiwan Community Hospital Association, Taiwan Medical Association, National Taiwan University Hospital, and Taiwan Healthcare Reform Foundation. On February 18, 2017, the MOHW announced that the new regulation is to be taken into force from April 15, 2017. The content of the regulation comprises the following matters:

(1)Co-payments for referrals to medical centers and regional hospitals will be reduced by NT$40; co-payments for medical centers will be reduced from NT$210 to NT$170, and from NT$140 to NT$100 for regional hospitals.

(2)Co-payments for direct visit to medical centers will be adjusted from NT$360 to NT$420.

(3)Co-payments for emergency triage levels 3 to 5 in medical centers will be adjusted from NT$450 to NT$550; levels 1 and 2 remain unchanged.

Copayment for Outpatient Care

  It is hoped that the current adjustments to co-payments will serve as a basis for building an effective referral system, thereby affecting the general public in altering their habitual way of seeking medical services in order to improve efficiency and encourage medical institutions to offer differentiated medical services that involve division of labor.

  • Date:2017-02-19